“I really feel like I’m getting my life back.” —First Lady Ann LePage
By Peter A. Steele
Governor Paul R. LePage made news last week when he announced he had undergone bariatric surgery to lose weight and improve his health, but he was not alone. His wife, First Lady Ann LePage, also had the weight-loss surgery.
The Maine media and people at public events had been speculating for months about the Governor’s noticeable weight loss. Was he on some kind of crash diet? Had he turned into a triathlete? Did he put a treadmill in his office to use while poring over legislation, budgets and vetoes? More importantly, was he sick?
Quite the contrary. In fact, thanks to bariatric surgery, the Governor—and the First Lady—are healthier now more than ever. At 68 and weighing in at a svelte 200 pounds with a 34-inch waist, the Governor hasn’t been this slim since his college days. He’s lost 53 pounds so far and may continue to lose more.
Preparing to travel to the 58th Presidential Inauguration, the Governor reached into his closet and pulled out a tuxedo that is nearly 25 years old. It fit perfectly, no alterations needed—just a good dry cleaning. He also has an Italian suit that fits perfectly; this one he got at Levine’s, a family-owned clothing store and local landmark in Waterville, which was founded in 1891 and closed in 1996.
“I really get the biggest chuckle out of it,” said the Governor. “I’m wearing a suit from a store that closed 20 years ago.”
The Governor and First Lady each had a minimally invasive weight-loss procedure called a sleeve gastrectomy at the renowned Central Maine Bariatric Surgery at Central Maine Medical Center in Lewiston. Jamie Loggins, M.D., medical director of Central Maine Bariatric Surgery and an expert at robotic and laparoscopic surgery, performed the procedures on the Governor and the First Lady.
“Both the Governor and the First Lady met the National Institute of Health guidelines for this kind of surgery,” he said.
Many still believe bariatric surgery is a radical procedure reserved for people who are hundreds of pounds overweight. But today, with the obesity epidemic growing across the country, the NIH considers people who either have a Body Mass Index greater than 40 or who are more than 100 pounds overweight good candidates for bariatric surgery.
People who have a BMI of 35 or greater also qualify if they have at least two obesity-related risk factors, called “co-morbidities,” including Type II diabetes, hypertension, sleep apnea, non-alcoholic fatty liver disease, osteoarthritis, gastrointestinal disorders or heart disease.
That means even people with less than 100 pounds to lose, but who have co-morbidities, can be good candidates for the surgery. Candidates for bariatric surgery also must have shown an inability to lose weight and keep it off for a sustained period.
Dr. Loggins said most private insurance companies, as well as Medicare and Medicaid, now accept bariatric surgery as a safe, reasonable and effective treatment of obesity because it resolves the co-morbidities associated with it.
“Severe obesity is a disease, plain and simple,” he said. “There’s a reason they call it morbid obesity. Someone with severe obesity has a 60 percent greater chance of getting cancer than another individual who is not obese. It can kill you.”
The cost savings to insurance companies is considerable because bariatric surgery prevents much more expensive health problems, such as heart attacks, some forms of cancer, liver disease and diabetes—and it averts a lifetime of dependency on expensive medications.
Although Dr. Loggins has performed over 2,000 bariatric surgeries, the LePages were certainly his most high-profile patients. The Governor had the surgery in September, while the First Lady had it in December.
The sleeve gastrectomy leaves a smaller, banana-shaped stomach with a reduced capacity. Patients who have the sleeve procedure eat less, which decreases their caloric intake while helping them feel satiated.
Another more commonly known procedure, often used for patients with more weight to lose, is gastric bypass, in which a surgeon re-routes the digestive system, leaving a very small, egg-size stomach.
Since the sleeve procedure is done laparoscopically, the surgery is minimally invasive and recovery is remarkably fast. It’s possible for patients to walk out of the hospital on the same day of surgery, but doctors recommend an overnight stay. In fact, Dr. Loggins said patients recover so quickly, they may start to resume normal activity too fast.
The Governor points to the First Lady. “I saw her picking up a heavy box the other day and said, ‘Ann! You can’t do that!’ ” The First Lady, well known as a dynamo who is constantly in motion, just laughs and waves him off.
Nor did the Governor, often accused of being a workaholic, miss a beat. He was back working the next day. “Yeah, but I was just sitting down reading,” he said.
Some people assumed Governor LePage had the same kind of surgery another high-profile patient had: New Jersey Governor Chris Christie. However, Governor Christie had a lap-band procedure, which consists of an adjustable band placed around the stomach to restrict food intake.
That procedure is much different than a sleeve gastrectomy. In his experience, Dr. Loggins said the lap-band is not as effective as other surgeries. When he overheard a patient at the hospital say he wanted to get the same lap-band surgery the Governor had, Dr. Loggins wanted to speak up. Unable to break patient confidentiality, he simply smiled and said nothing.
So what convinced the Governor to have this life-altering surgery? “I didn’t want to lose my feet,” he said.
His mother was born a Type I diabetic and suffered from it her entire life, even losing her feet to the disease. Diabetes runs among many of his family members, and the Governor was diagnosed with pre-diabetes. A former smoker, he also had high blood pressure and sleep apnea.
As for eating habits, the Governor confesses to always eating too fast. He is not unlike many people in his generation who were taught to eat more than they needed to. “When I was growing up, you were told to finish your plate or you would be punished,” he said. “That was a major factor.”
In addition to the more common risk factors, the Governor also learned years ago he had a dysfunctional thyroid. Bariatric surgery has already lowered his blood pressure, improved his cholesterol levels, relieved pressure on his knees and alleviated his back pain. It will most likely reduce the amount of thyroid medication he takes.
Although some patients are apprehensive about bariatric surgery, Governor LePage was determined to do it. “Obesity is a killer. If you have high blood pressure or diabetes, this surgery will save your life,” he said. “Once I make a decision, I do it and move on.”
Nor did First Lady Ann LePage hesitate. Her father was obese and had diabetes, suffering 13 strokes during his lifetime. She too was diagnosed as pre-diabetic and had sleep apnea.
Now 58, “I’ve been struggling with my weight since I was 10-years-old,” she said. “I was not apprehensive at all. We decided to do it as a couple.”
Like most Americans, the LePages had tried different diets and exercise regimens in the past. “We’ve tried it all,” the First Lady said. “Cabbage soup, low-carb diets, everything. But as soon as you eat carbs, it comes right back.”
The Governor, who would intensify his workouts to lose weight, said he was once able to get down to 217 pounds. But then the weight came back. “It never stays off,” he said. “You can’t work out six hours a day. It won’t stay off until you change your lifestyle and change the way you eat.”
The First Lady said getting enough exercise was never a problem for her. “I am an avid exerciser,” she said. “It was the food I put in my mouth afterward.”
Patients go through an extensive process at Central Maine Bariatric, which begins months before the surgery and requires a lifelong commitment to healthy eating, dietary changes and exercise after the procedure.
“This is a program, not just a procedure,” said Dr. Loggins. “It is not an easy fix. There is nothing easy about this process. The procedure is just a tool. If they don’t use the tool properly, it won’t work.”
Patients often must learn to eat again. The surgery can sometimes alter what they like to consume, even if it was their favorite food or beverage before the surgery. Both LePages have lost their taste for coffee, but it will most likely return in time. Most patients can no longer eat overly greasy or sweet foods; if they do, it can make them feel nauseous.
The Governor has lost his taste for prepared foods. “The more I look at it and see the ingredients in it—I just have no desire for it,” he said.
“It forces you to make the right choices because you can’t eat as much,” said the First Lady.
Both LePages say they have more energy and haven’t felt this good in years. The Governor’s favorite hobby is woodworking, but with his exhausting schedule and extra weight, he wasn’t able to enjoy it over the past couple of years. “I did two chairs and a bookcase this weekend,” he said. “There’s no question, you will have a lot more energy.”
“It will give you back 10 years of your life,” Ann said. “I really feel like I’m getting my life back.”
Since many people are still reluctant to tackle their weight problem, “it’s great that the Governor and the First Lady are creating awareness,” Dr. Loggins said. Both LePages are very satisfied with the results of their surgeries and highly recommend it to anyone who is considered obese.
“We’re doing our part for obesity,” Governor LePage said. “Once you’re healthy, why would you give it up? You want to stay healthy. And,” he says with a laugh, “there’s 50 pounds less of me to hate.”
Peter A. Steele is the communications director for the Office of Governor Paul R. LePage. He and his wife, Laurie, are founders and owners of Twin City TIMES.